Obesity is linked to many long-term health issues. However, sometimes diet and exercise are not enough, and medical intervention with bariatric surgery is needed to help some patients reach their weight loss goals and live healthier lives. For many people suffering from severe obesity, bariatric procedures like Vertical Sleeve Gastrectomy (VSG) and Endoscopic Sleeve Gastroplasty (ESG) aim to reduce stomach size, limit food intake, and promote significant weight loss. When comparing these two approaches, VSG emerges as the better option for many reasons and is a frequently performed weight loss surgery in Tijuana and Cancun at Renew Bariatrics.
Understanding VSG and ESG
What is Vertical Sleeve Gastrectomy (VSG)?
Vertical sleeve gastrectomy (VSG), also known as a gastric sleeve, is a surgical procedure that involves removing about 75-80% of the stomach, and creating a banana-shaped “sleeve.” This irreversible procedure not only restricts the amount of food you can eat but also significantly reduces levels of ghrelin, the hunger hormone. VSG is typically performed laparoscopically, meaning it involves small incisions and a faster recovery compared to traditional open surgery.
What is Endoscopic Sleeve Gastroplasty (ESG)?
ESG, on the other hand, is a non-surgical, minimally invasive procedure performed using an endoscope. The endoscope is inserted through the mouth, and sutures are used to reduce the size of the stomach, mimicking the effect of a sleeve without actual removal of stomach tissue. Because it doesn’t involve incisions or permanent alterations to the stomach, ESG is often marketed as a less invasive option for weight loss.
Key Differences Between VSG and ESG
| Feature | VSG | ESG |
| Invasiveness | Surgical | Non-surgical |
| Durability | Permanent | Reversible |
| Weight Loss Potential | Significant (60-70% of excess weight) | Moderate (20-50% of excess weight) |
| Hunger Hormone Impact | Reduces ghrelin significantly | Minimal impact |
| Insurance Coverage | Widely covered | Limited coverage |
| Long-term Data | Established long-term success | Limited long-term evidence |
Why VSG is the Superior Option
- More Significant Weight Loss The primary goal of bariatric procedures is sustainable weight loss. VSG has consistently demonstrated superior outcomes compared to ESG. On average, patients undergoing VSG lose 60-70% of their excess body weight, while ESG patients typically achieve 20-50%. The difference is primarily due to VSG’s ability to physically remove most of the stomach, drastically limiting food intake and reducing appetite.
- Reduction in Hunger Hormones A unique advantage of VSG is its impact on hormones. By removing the portion of the stomach that produces the hunger hormone, patients often experience a significant decrease in appetite. ESG, in contrast, doesn’t remove any part of the stomach, so its effect on hunger regulation is minimal. For individuals who struggle with uncontrollable cravings, this hormonal change can be a game-changer.
- Permanent Results VSG is a permanent solution. By physically altering the stomach, it ensures that the changes are long-lasting. ESG, being a reversible procedure, can lose its effectiveness over time as the sutures may loosen and the stomach returns to its original size. This can lead to weight regain, negating the initial benefits of the procedure.
- Established Long-Term Success VSG has been performed for decades and boasts a wealth of data supporting its effectiveness and safety over the long term. Patients can confidently undergo the procedure knowing that it has a proven track record. ESG, on the other hand, is a newer technique with limited long-term studies available. While initial results are promising, its durability and sustained weight loss benefits remain uncertain.
- Better for Severe Obesity For individuals with a higher BMI (Body Mass Index) or severe obesity, VSG is often the recommended choice. ESG is typically geared toward individuals with a lower BMI who need to lose a smaller amount of weight. For those requiring more drastic weight loss to address health conditions like diabetes, hypertension, or sleep apnea, VSG is more effective.
- Comprehensive Health Benefits VSG has been shown to provide substantial improvements in obesity-related health conditions. Many patients experience remission of type 2 diabetes, improved cardiovascular health, and reduced joint pain after surgery. While ESG can also offer health benefits, they are generally less pronounced due to the smaller amount of weight lost.
- Greater Insurance Coverage Insurance coverage is a critical factor for many individuals. VSG is widely recognized as a medical necessity for individuals with severe obesity and related health issues, making it eligible for coverage under most insurance plans. ESG, being a newer and less established procedure, is often not covered, requiring patients to pay out of pocket.
The Case for ESG: Situational Benefits
While VSG has numerous advantages, ESG does have its place. It can be a viable option for individuals who:
- Have a lower BMI and don’t qualify for traditional bariatric surgery.
- Are seeking a reversible, non-surgical approach.
- Want a shorter recovery time with minimal downtime.
However, for those with significant weight to lose or who prioritize long-term success, VSG remains the superior option and one we perform frequently at Renew Bariatrics.
Choosing the Right Procedure
When deciding between VSG and ESG, it’s essential to consider your individual goals, health needs, and long-term expectations. VSG offers a proven, permanent solution for those seeking significant and sustained weight loss, with the added benefit of hormonal changes that make it easier to maintain results. ESG, while less invasive, may be better suited for individuals with less weight to lose or those unable to undergo surgery. For most patients facing severe obesity, VSG remains the gold standard in weight loss surgery, which is why our surgeons offer VSG.
Ready to consult with a qualified bariatric surgeon to explore your options and determine which procedure aligns best with your health and lifestyle? Contact Renew Bariatrics to explore our bariatric surgeries in Tijuana and Cancun.
